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Biomedical subjects

M Gomibuchi

Publications and source records attributed to M Gomibuchi.

12 recordsLinked to original sources
PubMed1992

[Changes in left ventricular function during exercise after lung resection--study with a nuclear stethoscope].

In 29 cases undergoing lung resection, effects of the surgery on left ventricular function were investigated indirectly with a Nuclear Stethoscope. Various parameters were measured following an exercise load before and after surgery. There were significant decreases in post-operative resting levels of stroke volume (SV) (p < 0.001), end-diastolic volume (EDV) (p < 0.001), ejection fraction (EF) (p < 0.05) and ejection rate (ER) (p < 0.001) and significant increase in heart rate (HR) (p < 0.001) when compared to pre-operative resting levels. Neither filling rate (FR) nor cardiac output (CO) showed significant difference. At maximum exercise load, there were significant decreases in post-operative EDV (p < 0.005), SV (p < 0.005), ER (p < 0.001) and FR (p < 0.005), but no significant differences were detected in HR and EF; consequently, there was a significant decrease in CO (p < 0.005). Ratio of the levels at maximum load to those at resting of each parameter did not show significant difference between before and after operation with regard to any parameters except CO and FR which showed significant decrease (p < 0.005 and p < 0.001, respectively). Effects of the surgery on left ventricular function were studied according to amount of lung resection. In 13 cases where more than two lobes were resected, similar significant differences to those mentioned above were found in all parameters except EF. In cases where a single lobe was resected, only ER and FR showed similar tendency to that described above. Effects of the surgery on left ventricular function were also studied according to age of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Prediction of postoperative exercise capacity in lung resection candidates].

The relation between submaximal oxygen consumption (MVO2) before and after lung resection was studied, and the possibility to predict postoperative MVO2 was investigated. Thirty four patients (19 lobectomies, 9 bi-lobectomies, 6 pneumonectomies) performed exercise tests one week before operation and at the time when they were able to resume work daily after operation (in two to eleven months). Predicted postoperative MVO2 was calculated from preoperative MVO2 as follows: 0.8 x resection rate x age index x preoperative MVO2 + 183. In this formula the resection rate means [the number of total lung segments--the number of non-working segments]. The age index is 1.5 for patients under 50 years, 1.0 for those between 50 to 69, and 0.8 for those over 70. This predicted MVO2 had strong correlation with actual postoperative MVO2 (r = 0.94, t = 13.4, y = 1.08x - 83) in twenty five patients. Correlation was low in the remaining nine patients, however. The nine had old myocard infarction, postoperative cerebral infarction, marked wet lung, anticancerous chemotherapy within ten days or marked reduced exercise capacity (below 3 METS at maximal exercise). From these results, we concluded it is possible to predict the postoperative MVO2 using preoperative MVO2 except in cases which have some exercise limiting factors or whose exercise capacity is very small.

Adult↗
PubMed1991

[Management of pain after thoracotomy: experience of intercostal nerve block with alcohol during operation].

Post-thoracotomy wound pain in 11 patients who underwent thoracic operation was controlled by intercostal nerve block with alcohol and thoracic epidural anesthesia. The intercostal nerve block was performed just before the closure of the thoracotomy wound. Epidural anesthesia was employed from the 1st to 5th post operative day. This method alleviated post-thoracotomy pain and obviated postoperative pulmonary complication in all patients in early post operative periods. In late post operative periods after discharge, intercostal nerve block could maintain excellent analgesia in 9 of 11 patients, only 2 patients required analgesic drugs or re-block of the intercostal nerve. Thus, intercostal nerve block with alcohol is an effective and simple option to control recalcitrant post-thoracotomy wound pain in thoracic surgery.

Adult↗
PubMed1990

[A case of malignant aortico-pulmonary paraganglioma].

A 64-year-old male was admitted to our hospital suffering from dysphagia and dyspnea. The chest X-ray films and chest CT films revealed huge tumor in his upper-anterior mediastinum. The filling defect at lower rim of the left brachiocephalic vein on venography indicated malignant potential of the tumor. There was no abnormal value in blood and urine examinations except CA 19-9 which was 31.8 U/ml. The tumor was resected with bilateral pleura, pericardium and left brachiocephalic vein. Macroscopically the specimen accompanied with a lot of bleeding spots was soft and yellow and has no capsule. The size of tumor was 15 X 13 X 8 cm and its weight was 865 gm. No tumor recurrence was found until present time: two years after surgical therapy followed by adjuvant radiation therapy (60 Gray). Though histological findings of anterior part of the tumor were consisted of "Zellballen" cells and bleedings, the posterior part had cell atypia and invasion into vessels. These cells were slightly positive on Keratin stain and on NSE stain. Typical findings of paraganglioma were also indicated by electron microscopy: those findings were more chief cells, fewer sustentacular cells, abundant mitochondria and few dense-cored granules which are thought to secrete hormonal substances. Judging from these clinical and pathological results, this tumor was diagnosed nonfunctional aortico-pulmonary paraganglioma. Mediastinal paraganglioma is a very rare tumor. There is no report of malignant aortico-pulmonary paraganglioma in Japan after Glenner and Grimelys' study concerning extra-adrenal paraganglion system.

Aorta↗
PubMed1990

[Respiratory function on exercise as a predictor of complications after lung resection].

We studied the correlation between the complications after pulmonary resection and the results of exercise testing and others. The exercise testing was performed preoperatively on 64 patients; 44 lobectomies, 6 bilobectomies and 14 pneumonectomies. The results which had the correlation with postoperative complications were RV/BSA (p less than 0.001), RV/TLC (p less than 0.005), VE/VCO2 (p less than 0.001) and VO2/VE (p less than 0.001). Men had more complications than women (p less than 0.001). And the patients with the past histories concerning cardiovascular disease, pulmonary disease and/or diabetes had more chances of complications than the patients without those histories (p less than 0.05). Judging from these results we concluded that the patients with one or more of the following results had more chances of postoperative complications. 1. maximum VO2/VE was less than 40 ml/l. 2. VE/VCO2 was more than 4.0 l/ml. 3. RV/BSA was more than 1.5 l/m2. 4. RV/TLC was more than 45%.

Adult↗
PubMed1989

[Surgical treatment of metastatic lung cancer arising from the colon and rectum].

Ten cases of surgically resected pulmonary metastases arising from colorectal cancer were analyzed. Five year survival rate of these patients was 14%. Only one patient survived more than five years, whose primary and metastatic lesions were not so progressive without lymph node metastasis. The rate of regional lymph node metastasis was 25% and the patients with positive nodes died or had recurrence within 2 years. Serum CEA level was useful as a tumor marker and high-level of serum CEA after operation suggested remnant disease.

Aged↗
PubMed1989

[The treatment of traumatic chylothorax].

Traumatic chylothorax is classified as follows; postoperative and nonsurgical. We have encountered 5 cases of traumatic chylothorax, 2 after resection of lung cancer, 2 after repair of congenital heart disease and 1 after blunt chest injury. The incidence of this complication was 0.2% after surgery for cardiovascular diseases, and 0.6% for lung cancer in our institute. We carried out operation two cases successfully, one after resection for lung cancer and the other for Tetralogy of Fallot. The treatment should be determined according to the condition of the underlying diseases. We choose conservative therapy at first which is generally recommended. When chylous discharge continues, conservative therapy should be carried out when new operative skin incision is necessary for the treatment of chylothorax. Operative therapy is desirable in cases with pulmonary resection which makes dead space in pleural cavity.

Adult↗
PubMed1986

Radioimmunodetection of human melanoma tumor xenografts with human monoclonal antibodies.

We established a human IgM monoclonal antibody that defines a tumor-associated membrane antigen expressed on human melanoma cells. The antigen has been identified as the ganglioside GD2. In this paper, we describe the potential usefulness of the human monoclonal antibody for radioimaging. Nude mice bearing tumors derived from a human melanoma cell line were used as a model. Antibody activity was degradated significantly after labeling with 131I by the use of a modified chloramine-T method. After testing various concentrations, labeled antibody of a specific activity of 2.8 microCi/micrograms produced the best results. Balb/c nude mice bearing a GD2-positive M14 melanoma cell line were injected with 10-30 micrograms of labeled antibody, and its radiolocalization in different organs and in the whole body were evaluated. The best tumor image was obtained on Day 6. The labeled antibody uptake ratio between tumor and muscle was 9.2:1; the ratio between tumor and liver was 1.4:1. These studies represent the first report of experimental tumor imaging with human monoclonal antibody. Human monoclonals with probably prove to be superior reagents for tumor imaging in melanoma patients if the problem of antibody radiolysis is resolved.

Animals↗